Written off 'Rolls-Royce'

In the mid-1980s, Greenwich District Hospital looked as if it had a future. The 1960s building was due to be redeveloped, allowing specialist services to move from neighbouring hospitals. Plans included a tunnel link to new buildings over the road, moving car parking to the roof and reducing reliance on air-conditioning. But NHS reorganisation intervened and the hospital has now been written off under the private finance initiative.

Howard Goodman argues that the building's flexibility and the potential to add another storey meant it could have served the NHS superbly for years to come. 'Instead they have gone for a monstrous ex-military hospital.' Both he and Professor Raymond Moss believe that the management let it down.

Lack of vision and the fact that it has been 'undercapitalised' has stopped it being a 'Rolls-Royce' building, says Professor Moss. 'But even hobbling along, it has been a trendsetter.'

Director of facilities Peter Ballard, says the design has allowed 'very significant' internal reconfigurations. And the engineering 'sandwich' floors, although staff-intensive, mean repairs can be carried out without disruption.

The building had an asbestos problem and the air conditioning makes it 'energy expensive'. Though patients have an outside view 'some staff have to live without natural daylight'. But generally, 'although people knock the design, I think it's unknockable'.

The main reason for selling in favour of the Queen Elizabeth site in Woolwich, he says, is the high operational cost, particularly of the wards.

Financial penalties are being lifted from high-profile standards including cancer and elective waiting times, so far without attracting much attention. How is this happening? And will it work, asks Rob Findlay